Bone Fixation System Including An Implant Having A Plate Portion And A Mesh Portion

ABSTRACT

A bone fixation system is configured to be implanted and secured to a bone so as to stabilize a bone. The bone fixation system includes an implant having a plate portion configured to be secured to a first segment of the bone by a first bone anchor, and a second segment of the bone by a second one anchor. The implant further includes a mesh portion configured to abut a third segment of the bone to prevent movement of the third segment relative to both the first segment and the second segment. The implant defining an outer perimeter defined in part by the plate portion and in part by the mesh portion.

TECHNICAL FIELD

This disclosure relates generally to bone fixation, and in particularrelates to a bone fixation system provides compression to enhance thestabilization of bone fractures.

BACKGROUND

Many types of bone fixation systems are conventionally available tostabilize bone fragments following bone fractures to promote bonehealing. Bone fixation systems typically include a bone plate that isplaced against the bone across the fracture location. Bone anchors,typically configured as bone screws, are driven through bone fixationholes of the bone plate and into the respective underlying bonefragments. The bone fragments are thus stabilized with respect to thebone plate and each other. The bone fragments can be compressed towardeach other prior to reduce the fracture prior to fixation of the boneanchors.

Bone screws are conventionally available as locking screws ornon-locking screws (also known as compression screws). Locking screwsare configured to lock to the bone plate. For instance, locking screwstypically can be externally threaded at the screw head, and the boneplate typically includes threading in the fixation hole. The lockingscrew is inserted through the fixation hole of the bone plate, androtated to gain purchase with the underlying bone as it is driven intothe bone. The locking screw is rotated until the screw head is insertedinto the fixation hole, at which point the threading of the screw headpurchases with the threading in the fixation hole. Thus, the lockingscrew is locked to the bone plate, thereby creating a fixed angleconstruct and preventing back out of the bone screw.

Alternatively, the bone screws can be configured to compress the boneplate against the underlying bone. In particular, the external surfaceof the bone screw can be unthreaded. Accordingly, the bone screw isdriven into the underlying bone until the screw head bears against thebone plate (typically in the fixation hole). Continued rotation of thebone screw causes the screw head to compress the bone plate against theunderlying bone. This can be useful when it is desired to compress twoor more bone fragments against each other to promote bone healing.Unfortunately, conventional locking screws are not also configured tocause compression of the bone plate against the underlying bone.

Unfortunately, many high-energy fractures produce highly comminutedfractures that are not easily addressed with conventional bone platingtechniques. Intra-articular and juxta-articular fractures typicallyresult in highly comminuted fractures. In particular, the small bonefragments associated with highly comminuted fractures are too small toreceive bone screws. As a result, these bone fragments are often leftuntreated.

It is therefore desirable to provide a bone plate that is configured tostabilize highly comminuted bone fractures.

SUMMARY

The following Summary is provided to introduce a selection of conceptsin a simplified form that are further described below in the DetailedDescription of Illustrative Embodiments. This Summary is not intended toidentify key features or essential features of the invention, nor is itintended to be used to limit the scope of the invention. Reference ismade to the claims for that purpose.

In accordance with an aspect of the disclosure, the applicationdiscloses an implant including a plate portion and a mesh portion,wherein the implant defines an outer perimeter defined at leastpartially by the plate portion and further defined at least partially bythe mesh portion.

In accordance with an aspect of the disclosure, the applicationdiscloses a method of stabilizing a bone, the bone including a firstbone fragment, a second bone fragment, a third bone fragment, a firstdefect between the first bone fragment and the second bone fragment, anda second defect between the second bone fragment and the third bonefragment. The method includes the step of moving an implant toward thebone, the implant includes a plate portion, a mesh portion, and an outerperimeter defined in part by the plate portion and in part by the meshportion. The method further includes the step of inserting a bone anchorthrough a first bone fixation hole defined by the plate portion, andinto the first bone segment, inserting a second bone anchor through asecond bone fixation hole defined by the plate portion, and into thesecond bone segment, and abutting the mesh portion with the third bonesegment.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing summary, as well as the following detailed description ofillustrative embodiments of the application, will be better understoodwhen read in conjunction with the appended drawings. For the purposes ofillustrating the present disclosure, there is shown in the drawingsillustrative embodiments. It should be understood, however, that theapplication is not limited to the specific embodiments and methodsdisclosed, and reference is made to the claims for that purpose. In thedrawings:

FIG. 1 is an exploded perspective view of a bone fixation systemaccording to one aspect of the disclosure, the bone fixation systemincluding an implant and a bone fixation member configured to attach theimplant to an underlying fractured bone;

FIG. 2 is a perspective view of the bone fixation system illustrated inFIG. 1, showing the implant attached to the underlying fractured bone;

FIG. 3 is a perspective view of the implant illustrated in FIG. 1according to one embodiment, the implant including a plate portion and amesh portion;

FIG. 4 is a side elevation view of the implant illustrated in FIG. 1;

FIG. 5 is a top plan view of the implant illustrated in FIG. 1 accordingto another embodiment, the implant including a plate portion and a meshportion;

FIG. 6 is a perspective view of the implant illustrated in FIG. 1according to another embodiment, the implant including a plate portionand a mesh portion;

FIG. 7 is a perspective view of the implant illustrated in FIG. 1according to another embodiment, the implant including a plate portionand a mesh portion;

FIG. 8 is a perspective view of the implant illustrated in FIG. 1according to another embodiment, the implant including a plate portionand a mesh portion;

FIG. 9 is a perspective view of the implant illustrated in FIG. 1according to another embodiment, the implant including a plate portionand a mesh portion;

FIG. 10 is an implant according to another embodiment;

FIG. 11 is a perspective view of a bone fixation system according toanother aspect of the disclosure, the bone fixation system including animplant and a bone fixation member configured to attach the implant toan underlying fractured bone;

FIG. 12 is a perspective view of the implant illustrated in FIG. 11;

FIG. 13 is a perspective view of a bone fixation system according toanother aspect of the disclosure, the bone fixation system including animplant and a bone fixation member configured to attach the implant toan underlying fractured bone; and

FIG. 14 is a perspective view of the implant illustrated in FIG. 13.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Certain terminology is used in the following description for convenienceonly and is not limiting. The words “lower” and “upper” designatedirections in the drawings to which reference is made. The words“proximally” and “distally” refer to directions toward and away from,respectively, the surgeon using the medical device. The words,“anterior”, “posterior”, “superior”, “inferior” and related words and/orphrases designate preferred positions and orientations in the human bodyto which reference is made and are not meant to be limiting. Theterminology includes the above-listed words, derivatives thereof andwords of similar import.

Aspects of the disclosure will now be described in detail with referenceto the drawings, wherein like reference numbers refer to like elementsthroughout, unless specified otherwise. Certain terminology is used inthe following description for convenience only and is not limiting. Theterm “plurality”, as used herein, means more than one. The terms “aportion” and “at least a portion” of a structure include the entirety ofthe structure. Certain features of the disclosure, which are describedherein in the context of separate embodiments, may also be provided incombination in a single embodiment. Conversely, various features of thedisclosure that are described in the context of a single embodiment mayalso be provided separately or in any subcombination.

Referring to FIGS. 1 to 2, many typical bone fractures result in a bonehaving a first bone segment separated from a second bone segment by adefect in the bone, for example the fracture. Sometimes a bonefractures, or splinters into more than two fragments. This type offracture or splinter of a bone can be referred to as a comminutedfracture. A comminuted fracture of a bone 2 can result in a first bonesegment 4, a second bone segment 6 separated from the first bone segment4 by a defect 6, and at least one additional bone segment 10. The atleast one additional bone segment 10 can be much smaller than each ofthe first bone segment 4 and the second bone segment 6. While an implantcan be secured to both the first bone segment 4 and the second bonesegment 6, for example through the use of a bone anchor such as a bonescrew, the small size of the additional bone segment 10 may discouragethe use of a bone anchor being inserted into the additional bone segment10 to secure the additional bone segment 10 to the implant.

A bone fixation system 12 is configured to be implanted and secured to abone 2 so as to stabilize a first bone segment 4 of the bone 2 withrespect to a second bone segment 6 of the bone 2, the first bone segment4 separated from the second bone segment 6 by a defect 8. The bonefixation system 12 is further configured to stabilize additional bonesegments 10 with respect to the first bone segment 4 and the second bonesegment 6. In one example, the bone 2 is a tibia. It should beappreciated, however, that the bone 2 can be any bone in the human oranimal anatomy suitable for bone plate fixation. Further, while the bone2 is illustrated having first and second bone segments 4 and 6, it isappreciated that the bone 2 can include any number of defects or bonesegments as desired that are configured for fixation using the bonefixation system 12.

The bone fixation system 12 can include an implant 20 and a plurality ofbone anchors 80 that are configured to fix the bone plate 20 to theunderlying bone 2, and in particular to each of the first and secondbone segments 4 and 6. The bone anchors 80 include a head 82 and a shaft84 that extends out with respect to the head 82 along a central anchoraxis 86. The shaft 84 can extend directly from the head 82, or canextend from a neck that is disposed between the head 82 and the shaft84. The shaft 84 can be threaded, such that the bone anchor 80 isconfigured as a bone screw 88 whose shaft 84 extends out relative to thehead 82 along the central anchor axis 86, which can also be referred toas a central screw axis. The threaded shaft 84 can be configured tothreadedly purchase in the underlying bone 2. For instance, one or moreup to all of the bone screw 88 can be configured as a cortical screwwhose threaded shaft 84 is designed and configured to threadedly mate tocortical bone. Alternatively or additionally, one or more of the bonescrews 88 can be configured as a cancellous screw whose threaded shaft84 is designed and configured to threadedly mate to cancellous bone. Itis appreciated that cancellous bone screws have threads that have agreater pitch than threads of cortical bone screws. Further, the threadsof cancellous bone screws typically extend out from the shaft 84 of thebone screw 88 a greater radial distance than the threads of corticalbone screws.

Referring now to FIGS. 1 to 5, the implant 20 includes a plate portion22 and a mesh portion 23. The plate portion 22 defines a plate body 24.The plate body 24, and thus the plate portion 22, defines an inner platesurface 26 configured to face the underlying bone 2, and an outer platesurface 28 that is opposite the inner plate surface 26. The plateportion 22 further defines a plurality of bone fixation holes 30 thatextend through the plate body 24 from the inner plate surface 26 to theouter plate surface 28. The bone fixation holes 30 may include holesconfigured to receive a permanent fixation device, for example bonescrews, nails, etc. The bone fixation holes 30 may further include holesconfigured to receive a temporary fixation device, for example a K-wire.In particular, the plate body 24, and thus the plate portion 22,includes a plurality of internal surfaces 32 that each extend from theouter plate surface 28 to the inner plate surface 26 and that eachdefine a respective one of the bone fixation holes 30. Each of the bonefixation holes 30 can extend from the outer plate surface 28 to theinner plate surface 26 along a central hole axis 34. The central holeaxis 34 can be oriented normal to each of the inner plate surface 26 andthe outer plate surface 28. It should be appreciated, of course, thatthe central hole axis 34 of any of the bone fixation holes 30 can beoriented at an oblique angle with respect to the inner plate surface 26and outer plate surface 28 as desired.

During a surgical procedure using the bone fixation system 12, the shaft84 of the bone screw 88 can be inserted through a respective one of thebone fixation holes 30 and into the underlying bone 2. The bone screw 88can then be rotated, for example about the central anchor axis 86, so asto cause the threaded shaft 84 to be driven into the underlying bone 2as the threaded shaft 84 threadedly purchases with the underlying bone2. The threaded shaft 84 can be driven into the underlying bone untilthe head 82 engages the implant 20.

One or more up to all of the bone screws 88 can be configured as acompression screw whose head 82 is configured to bear against theimplant 20 so as to apply a compressive force against the implant 20toward the underlying bone 2 when the shaft 84 is driven further intothe underlying bone 2 after the head 82 has contacted the internalsurface 32. The shaft 84 can be driven into the underlying bone asufficient distance until the desired compressive force has beenimparted onto the implant 20. The head 82 of the compression screw isoften unthreaded. Similarly, at least a portion up to an entirety of theinternal surface 32 can be unthreaded.

In another example, one or more up to all of the bone screw 88 can beconfigured as locking screws that are configured to lock to the implant20. In particular, the head 82 can be externally threaded. The internalsurface 32 can be similarly threaded so as to be configured tothreadedly mate with the threaded head 82. Accordingly, duringoperation, the shaft 84 can be inserted through the fixation hole 30 anddriven into the underlying bone 2 as described above. In particular,when the bone screw 88 is a locking screw, rotation of the screw 88causes the threaded head 82 to threadedly mate with the internal surface32. As a result, the screw head 82 fastens the implant 20 to theunderlying bone 2 without applying a compressive force onto the implant20 against the underlying bone 2. The implant 20 can be spaced from theunderlying bone 2 when locked to the head 82. Alternatively, the implant20 can abut the underlying bone 2 when locked to the head 82. At least aportion of the internal surface 32 is typically tapered so as to extendin an axially inward direction, for example toward the central hole axis34, as the internal surface 32 extends from the outer plate surface 28toward the inner plate surface 26. Thus, the internal surface 32 isconfigured to prevent the head 82 from passing completely through thefixation hole 30. The head 82 can define at least one external threadthat is circumferentially continuous about the central anchor axis 86.It should be appreciated, however, that the head 82 can be alternativelyconstructed in any manner desired so as to threadedly mate with theinternal surface 32 as described herein.

According to one embodiment, one or more of the fixation holes 38 of thebone plate 30 can be configured as a variable angle locking hole that isconfigured to threadedly mate with the bone screw 88 at differentorientations of the bone screw 88 with respect to the central hole axis34. That is, when the fixation hole 30 is configured as a variable anglelocking hole, the plate body 24, and thus the plate portion 22, includesat least one thread that projects out from the internal surface 32 intothe fixation hole 30.

The bone screw 88 can be configured to be inserted into the fixationhole 30 such that the central anchor axis 86 is at one of a plurality oforientations with respect to the central hole axis 34 within a range oforientations at which the threaded head 82 is configured to threadedlymate with the at least one thread in the fixation hole 30. For instance,the bone screw 88 can be configured to be inserted into the fixationhole 30 such that the central anchor axis 86 is at one of a plurality ofangles within a range of angles defined by the central anchor axis 86and the central hole axis 34 at which the threaded head 82 is configuredto threadedly mate with the at least one thread in the fixation hole 30.The range of angles can be from approximately zero degrees toapproximately fifteen degrees. Thus, the range of angles can define acone of up to approximately thirty degrees. Thus, it can be said thatthe at least one thread is configured to threadedly mate with thethreaded screw head 82 while the bone screw 88 is inserted into thefixation hole 30 such that the central anchor axis 86 is oriented at afirst angle with respect to the central hole axis 34, and the at leastone thread is further configured to threadedly mate with the threadedscrew head 82 when the bone screw 88 is inserted into the fixation hole30 such that the central anchor axis 86 is oriented at a second anglewith respect to the central hole axis 34 that is different than thefirst angle. At least one or both of the first and second angles can benon-zero angles. Alternatively, the central anchor axis 86 can becoincident with the central hole axis 34 in one of the orientations inthe range of orientations.

According to one aspect of the disclosure, the at least one thread inthe fixation hole 30 and the threads of the head 82 are defined prior toinsertion of the bone screw 88 into the variable angle locking hole.That is, the internal surface 32 is not designed or configured to cutthreads into the bone screw head 82. Similarly, the bone screw head 82is not designed or configured to cut threads into the internal surface32. According to another embodiment, the threads of the head 82 areconfigured to cut threads into the internal surface 32 when the centralanchor axis 86 is not coincident with the central hole axis 34.

According to one embodiment, one or more of the fixation holes 38 of thebone plate 30 can be configured as a combination hole that includes afirst portion configured to receive a compressive force from acompression screw, and a second portion configured to threadedly matewith a locking screw, a variable angle locking screw, or both. The firstportion and the second portion of the combination hole can be open toone another. One or both of the first portion and the second portion maydefine a substantially circular shape.

The plate body 24, and thus the plate portion 22, can include a shaftportion 36 and a head portion 38. In one example, the shaft portion 36is configured to overlie a first bone segment, and the head portion 38is configured to overlie a second bone segment. The shaft portion 36 iselongate along a central shaft axis 40, which may be substantiallystraight, or may include twists and curvatures to correspond to theshape of a bone to which the implant 20 is to be secured. The headportion 38 is elongate along a central head axis 42, which may besubstantially straight, or may include twists and curvatures tocorrespond to the shape of the bone to which the implant 20 is to besecured. As shown in the illustrated embodiment, the plate portion 22 isconfigured such that the central shaft axis 40 is angularly offset withrespect to the central head axis 42 by about ninety degrees. The plateportion 22 may be configured to correspond to an anterolateral distaltibia.

Each of the shaft portion 36 and the head portion 38 can include atleast one up to a plurality of the bone fixation holes 30. The shaftportion 36 may be configured such that the central shaft axis 40intersects one or more, up to all, of the bone fixation holes 30 in theshaft portion 36. The head portion 38 may be configured such that thecentral head axis 42 intersects one or more, up to all, of the bonefixation holes 30 in the head portion 38. The plate portion 22 definesan outer plate perimeter 44 that encloses all of the bone fixation holes30.

As shown in the illustrated embodiment, the plate body 24 defines a sideplate surface 46 that extends between the inner plate surface 26 and theouter plate surface 28, for example from the inner plate surface 26 tothe outer plate surface 28, such that the side plate surface 46 definesat least a portion of the outer plate perimeter 44 of the plate portion22. The side plate surface 46 can be described as facing radiallyoutward with respect to the central hole axis 34 of any of the bonefixation holes 30, while the internal surface 32 can be described asfacing radially inward with respect to the central hole axis 34 of thebone fixation hole 30 defined by the internal surface 32.

The plate body 24 defines a height H1 measured from the outer platesurface 28 to the inner plate surface 26 along a first direction D1. Thefirst direction D1 can be parallel to the central hole axis 34 of thebone fixation hole 30 that is closest to the location where the heightH1 is being measured. The first direction D1 can vary based on thelocation within the plate body 24 at which the height H1 is beingmeasured, due to twists or curvature of the plate body 24. In oneexample, the height H1 can be measured at a location 48 that is betweentwo of the bone fixation holes 30, and that intersects the central shaftaxis 40. The plate body 24 further defines a length L1 measured along asecond direction D2 that can be substantially perpendicular to the firstdirection D1. In one example, the second direction D2 is substantiallyparallel to the central shaft axis 40. The plate body 24 further definesa width W1 measured along a third direction D3 that can be substantiallyperpendicular to both the first direction D1 and the second directionD2. In one example, the third direction D3 is substantially parallel tothe central head axis 42. As shown in the illustrated embodiment, theplate portion 22 can be configured such that the plate body 24 defines amaximum value for the length L1, a maximum value for the width W1, and amaximum value for the height H1, wherein the maximum value for thelength L1 is greater than the maximum value for the width W1, and themaximum value for the width W1 is greater than maximum value for theheight H1.

The plate portion 22 may be configured to resist bending by hand.According to one embodiment, the plate portion 22 defines a stiffnessthat is sufficient to prevent changing the shape of the plate portion 22by hand. The plate portion 22 may further be configured to define astiffness that allows the shape of the plate portion 22 to be changedwith the use of tools, but prevents changing the shape of the plateportion 22 by hand.

The mesh portion 23 defines a mesh body 25. The mesh portion 23 isconfigured to cradle, or support, the additional bone segment(s) 10without the use of bone fixation elements (such as bone screws) beinginserted into each of the additional bone segments 10. The mesh body 25,and thus the mesh portion 23, defines an inner mesh surface 27configured to face an underlying bone, and an outer mesh surface 29 thatis opposite the inner mesh surface 27. In one example, the mesh portion23 can define at least one aperture 31, such as a plurality of apertures31, which extends through the mesh body 25 from the outer mesh surface27 to the inner mesh surface 29.

The apertures 31 can include a plurality of inner apertures 33 thatextend through the mesh body 25 along a fourth direction D4 from theouter mesh surface 27 to the inner mesh surface 29. The apertures 31,according to one embodiment, are smaller than the bone fixation holes 30of the plate portion 22. According to one embodiment, the apertures 31are sized such that the apertures 31 are too small to receive a K-wire.Thus, the apertures 31 are not configured to receive one of the boneanchors 80 that the bone fixation hole 30 are configured to receive.According to one embodiment, the apertures 31 are not configured toreceive any bone anchors. According to another embodiment, the apertures31 are configured to receive a bone anchor that is much smaller than thebone anchor 80, for example a bone anchor that is smaller in diameterthan a K-wire.

The mesh portion 23 may include a mesh outer perimeter 35 defined by themesh body 25. According to one embodiment, the mesh body 25 includes aside mesh surface 37 that extends between the inner mesh surface 27 andthe outer mesh surface 29 such that the side mesh surface 37 defines atleast a portion of the mesh outer perimeter 25. At least some up to allof the inner apertures 33 can be fully enclosed about their respectiveperimeters by the mesh body 25, for example the side mesh surface 37.

The apertures 31 can combine so as to define linkages 39. The linkages39 can be interconnected, elastic, flexible, or any combination thereof.Further, the linkages 39 can be monolithic with each other. The linkages39 in combination with the apertures 31 are configured to abut multiple,small bone segments and retain the segments in place while the boneheals resulting in reconnection of the multiple, small bone segments.

The mesh portion 23 can be configured to be flexible, resilient, orboth. The linkages 39 and apertures 31 can combine to define anelastically flexible region of the mesh body 25. The mesh portion 23 caninclude as many or as few apertures 31 as desired.

The mesh body 25 defines a height H2 measured from the outer meshsurface 29 to the inner mesh surface 27 along the fourth direction D4.The height H2 can be measured at a location 41 within the mesh portion23, for example on one of the linkages 39. The fourth direction D4 canbe parallel to first direction D1, or alternatively, can be oblique tothe first direction D1. The fourth direction D4 can be normal to theouter mesh surface 29 at the location at which the depth D4 is beingmeasured.

The mesh body 25 further defines a length L2 measured along a fifthdirection D5 that can be substantially perpendicular to the fourthdirection D4. In one example, the fourth direction D4 is substantiallyparallel to the second direction D2. The mesh body 25 further defines awidth W2 measured along a sixth direction D6 that can be substantiallyperpendicular to both the fourth direction D4 and the fifth directionD5. In one example, the sixth direction D6 is substantially parallel tothe third direction D3. As shown in the illustrated embodiment, the meshportion 23 can be configured such that the mesh body 25 defines amaximum value for the length L2, a maximum value for the width W2, and amaximum value for the height H2, wherein the maximum value for theheight H2 is less than each of the maximum value for the length L1 andthe maximum value for the width W1. As shown in the illustratedembodiment, the maximum value for the height H2 of the mesh portion 23can be less than the maximum value for the height H1 of the plateportion 22. According to one aspect of the disclosure, the maximum valuefor the height H2 of the mesh portion 23 may be between about 0.25 andabout 1.0 mm, and the maximum value for the height H1 of the plateportion 22 may be between about 1.25 mm to about 4.5 mm. According toone aspect of the disclosure, the implant 20 defines a ratio of themaximum value for the height H1 of the plate portion 22 to the maximumvalue for the height H2 of the mesh portion 23 of about 5:1.

The mesh portion 23 can be configured to be less stiff than the plateportion 22. For example, the mesh portion 23 can be configured to bebent by hand, while the plate portion 22 can be configured to resistbending by hand.

The implant 20 includes the plate portion 22 and the mesh portion 23,the mesh portion attached to the plate portion 22. The mesh portion 23can extend from the plate portion 22. As shown in the illustratedembodiment, the mesh portion 23 extends from a portion of the plateportion 22 such that the implant 20 defines an outer implant perimeter50 that is defined partially by the plate portion 22 and partially bythe mesh portion 23. For example, the outer implant perimeter 50 may bepartially defined by the outer plate perimeter 44 and partially by theouter mesh perimeter 35.

The plate portion 22 may be monolithic with the mesh portion 23 suchthat the plate portion 22 and the mesh portion 23 form a single member,and cannot be separated without plastically deforming the implant 20.The mesh portion 23 may extend from a portion, less than the entirety,of the side plate surface 46. According to one embodiment, the meshportion 23 extends only from the head portion 38 of the plate portion22. The maximum value of the width W2 of the mesh portion 23 may beequal to or less than the maximum value of the width W1 of the plateportion 22, the maximum value of the length L2 of the mesh portion 23may be less than the maximum value of the length L1 of the plate portion22, the maximum value of the height H2 of the mesh portion 23 may beless than the maximum value of the height H1 of the plate portion 22, orany combination thereof.

Referring to FIG. 6, according to one embodiment the apertures 31 caninclude at least one outer aperture 43, which is defined by the sidemesh surface 37 and open to an exterior of the implant 20. The at leastone outer aperture 43 of the apertures 31 can include a plurality ofouter apertures 43. In one example, each of the outer apertures 43 canbe configured as a slot that that extends into the mesh body 25 towardthe plate portion 22. The outer apertures 43 can be spaced from eachother, for example along the sixth direction D6. The outer apertures 43can be equidistantly spaced from each other, or alternatively, the outerapertures 43 can be spaced from each other at different distances.

Thus, the outer apertures 43 can divide the mesh body 25 into aplurality of petals 45 that extend in a direction, for example thesecond direction D2, the fifth direction D5, or both. Each one of thepetals 45 can be moved independently of the other petals 45. As shown inthe illustrated embodiment, the plurality of petals 45 can define acontinuous body, for example such that each of the petals 45 extendsfrom a common base portion 47 of the mesh body 25. The base portion 47can be attached directly to the plate portion 22. Alternatively, one ormore of the petals 45 may be separate from one another such that each ofthe petals 45 extends from a separate portion of the plate body 24.

Referring to FIGS. 7 to 9, the mesh portion 23 can include one or morebone fixation holes 49 configured to receive a bone anchor, for examplea bone anchor configured to be received by the bone fixation hole 30, tosecure the mesh portion 23 to an underlying bone segment. The bonefixation hole 49 can be surrounded by a combination of the linkages 39and the apertures 31, for example the inner apertures 33. According toone aspect of the disclosure, the mesh portion 23 may be configured suchthat the linkages 39 are flexible to allow the mesh portion 23 to becontoured to match an underlying bone without altering the integrity ofthe bone fixation hole 49 such that the bone fixation hole 49 is able toreceive a bone fixation element to secure the implant 20 to the bone 2.Thus, the mesh portion 23 may include the linkages 39 that arecontourable and the bone fixation hole 49 that is configured to receivea bone fixation element to secure the implant 20 to the bone 2 beforeand after the linkages 39 have been contoured.

The petals 45 can each include zero, one, or a plurality of the bonefixation holes 49. In one example, each of the petals 45 can include thesame number of the bone fixation holes 49. Alternatively, different onesof the petals 45 can include a different number of the bone fixationholes 49. As shown in FIG. 8, the bone fixation holes 49 may beconnected to the plate portion 22 by an arm 51 and separated fromsurrounding linkages 39. The arm 51 may have a width greater than thatof the linkages 39 in the mesh portion 23. As shown in FIG. 9, the bonefixation holes 49 may be connected directly to one or more of thelinkages 39.

Two or more of the bone fixation holes 49 can be aligned with respect toone or more of the second direction D2, the third direction D3, thefifth direction D5, and the sixth direction D6. As shown in theembodiment illustrated in FIG. 8, the mesh portion 23 includes a firstbone fixation hole 49 a and a second bone fixation hole 49 b that arealigned with respect to the third direction D3, and the sixth directionD6. As shown in the embodiment illustrated in FIG. 9, the mesh portion23 includes the first bone fixation hole 49 a, the second bone fixationhole 49 b, a third bone fixation hole 49 c, and a fourth bone fixationhole 49 d. The first bone fixation hole 49 a and the second bonefixation hole 49 b are aligned with respect to the third direction D3,and the sixth direction D6, the third bone fixation hole 49 c and thefourth bone fixation hole 49 d are aligned with respect to the thirddirection D3, and the sixth direction D6, the first bone fixation hole49 a and the third bone fixation hole 49 b are aligned with respect tothe second direction D2, and the fifth direction D5, and the second bonefixation hole 49 b and the fourth bone fixation hole 49 d are alignedwith respect to the second direction D2, and the fifth direction D5. Itwill be appreciated that other numbers and arrangements of the bonefixation holes 49 can be provided.

Referring to FIG. 10, the bone fixation system 12 may include an implant120 configured to be secured to a calcaneus bone to repair a defect inthe calcaneus bone. The implant 120 includes a number of featuressimilar to those described above in reference to FIGS. 1 to 9 such thatthe description of FIGS. 1 to 9 applies to the embodiment illustrated inFIG. 10, except where differences are highlighted below. Similarelements in FIGS. 1 to 9 and FIG. 10 are identified with referencenumbers increased by 100. Thus, for example, the description of the bonefixation holes 30 also applies to bone fixation holes 130 as describedherein.

The implant 120 includes a plate portion 122 and a plurality of meshportions 123. The plate portion 122 includes a plate body 124 thatdefines a serpentine shape. The plate portion 122 includes a pluralityof bone fixation holes 130 arranged along the serpentine shape. Theplate body 124 may include one or more extensions 152 from theserpentine shape. The extensions 152 can include another of the bonefixation holes 130.

The plurality of mesh portion 123 extend from spaced locations of theplate portion 122, such that the plurality of mesh portions 123 arespaced from each other by portions of the plate portion 122. As shown inthe illustrated embodiment, a first mesh portion 123 a is spaced from asecond mesh portion 123 b by a first extension 152 a of the plateportion 122. The implant 120 can further include a third mesh portion123 c spaced from the second mesh portion 123 b by a second extension152 b of the plate portion 122. The second extension 152 b is spacedfrom the first extension 152 a by the second mesh portion 123 b. Thus,the implant 120 defines an outer implant perimeter 150 defined byalternating portions of the plate 122 and mesh portions 123. As shownthe outer implant perimeter 150, starting at a location 154 and goingcounter-clockwise, is defined by the plate portion 122, the first meshportion 123 a, the plate portion 122, the second mesh portion 123 b, theplate portion 122, and the third mesh portion 123 c, and the plateportion 122.

The implant 120 can include one or more tabs 154 configured to be bentto correspond to a shape of an underlying bone. The tabs 154 can bedevoid of bone fixation holes 130. The plate portion 122, one or more ofthe mesh portions 123, or both can include one or more of the tabs 154.

Referring to FIGS. 11 and 12, the bone fixation system 12 may include animplant 220 configured to be secured to a tibia bone to repair a distaltibia pilon fracture. The implant 220 includes a number of featuressimilar to those described above in reference to FIGS. 1 to 9 such thatthe description of FIGS. 1 to 9 applies to the embodiments illustratedin FIGS. 11 and 12, except where differences are highlighted below.Similar elements in FIGS. 1 to 9 and FIGS. 11 to 12 are identified withreference numbers increased by 200. Thus, for example, the descriptionof the bone fixation holes 30 also applies to bone fixation holes 230 asdescribed herein.

The implant 220 includes a plate portion 222 and a mesh portion 223. Theplate portion 222 includes a plate body 224, the plate body 224including a shaft portion 236 and a head portion 238. In one example,the shaft portion 236 is configured to overlie a first bone segment, andthe head portion 238 is configured to overlie a second bone segment. Theshaft portion 236 is elongate along a central shaft axis 240, which maybe substantially straight, or may include twists and curvatures tocorrespond to the shape of a bone to which the implant 220 is to besecured. The head portion 238 is elongate along a central head axis 242,which may be substantially straight, or may include twists andcurvatures to correspond to the shape of the bone 2 to which the implant220 is to be secured. As shown in the illustrated embodiment, the plateportion 222 is configured such that the central shaft axis 240 isangularly offset with respect to the central head axis 242 by aboutninety degrees.

The mesh portion 223 extends from the head portion 238 in a plurality ofdirections. As shown in the illustrated embodiment, the head portion 238can be surrounded by mesh portion 223 except for where the shaft portion236 joins to the head portion 238. The mesh portion 223 can extend fromthe head portion 238 in both directions that make up a lateral directionA, for example the mesh portion 223 can extend out from one portion 260of a side plate surface 246, and can further extend out from anotherportion 262 of the side plate surface 246 that is opposite the oneportion 260 with respect to the lateral direction A. The mesh portion223 can extend from the head portion 238 in both directions that make upa longitudinal direction L, for example the mesh portion 223 can extendout from one portion 264 of the side plate surface 246, and can furtherextend out from another portion 266 of the side plate surface 246 thatis opposite the one portion 264 with respect to the longitudinaldirection L. The mesh portion 223 can define a maximum dimension, forexample a maximum width W2 greater than a maximum width W1 of the plateportion 222. As shown the maximum width W2 and the maximum width W1 canbe measured along the lateral direction A. The mesh portion 223 may beconfigured to be cut, such that sections of the mesh portion 223 may beremoved to allow the remaining portion of the mesh portion 223 to havean improved fit with the underlying bone.

Referring to FIGS. 13 and 14 the bone fixation system 12 may include animplant 320 configured to be secured to a radius bone to repair a distalradius fracture. The implant 320 includes a number of features similarto those described above in reference to FIGS. 1 to 9 such that thedescription of FIGS. 1 to 9 applies to the embodiments illustrated inFIGS. 13 and 14, except where differences are highlighted below. Similarelements in FIGS. 1 to 9 and FIGS. 13 to 14 are identified withreference numbers increased by 300. Thus, for example, the descriptionof the bone fixation holes 30 also applies to bone fixation holes 330.

The implant 320 includes a plate portion 322 and a mesh portion 323. Theplate portion 322 includes a plate body 324, the plate body 324including a shaft portion 336 and a head portion 338. In one example,the shaft portion 336 is configured to overlie a first bone segment, andthe head portion 338 is configured to overlie a second bone segment. Theshaft portion 336 is elongate along a central shaft axis 340, which maybe substantially straight, or may include twists and curvatures tocorrespond to the shape of a bone to which the implant 320 is to besecured. The head portion 338 is generally aligned with the shaftportion 336, and the head portion 338 is enlarged, or wider than theshaft portion 336 to accommodate a plurality of bone fixation holes 330.The mesh portion 323 extends from the plate portion 322, for example,the head portion 338 in a direction substantially parallel to thecentral shaft axis 340.

Referring to FIGS. 1 to 14, a method of use of the bone fixation system12 is described below. Reference is made to the implant 20, the plateportion 22, and the mesh portion 23 but it will be understood that thesteps below may also be performed with any of the implants 120, 220, and320. A method of stabilizing a fractured bone 2 may include the step ofselecting an implant 20 including a plate portion 22 and a mesh portion23, the plate portion 22 configured to be secured to both a first bonesegment 4 of the bone 2, a second bone segment 6 of the bone 2 that isseparated from the first bone segment 4 by a defect 8 in the bone 2, andthe mesh portion 23 configured to abut at least one additional segment10 of the bone 2.

The method can include the step of positioning the implant 20 adjacentthe bone 2 such that a shaft portion 36 of the plate portion 22 facesthe first bone segment 4 and a head portion 38 of the plate portion 22faces the second bone segment 6. The positioning step can furtherinclude the step of abutting the mesh portion 23 with the at least oneadditional segment 10 of the bone 2. The shaft portion 36 includes afirst bone fixation hole 30 and the head portion 38 includes a secondbone fixation hole 30. The method can include the steps of inserting afirst bone anchor 80 through the first bone fixation hole 30 and intothe first bone segment 4, and inserting a second bone anchor 80 throughthe second bone fixation hole 30 and into the second bone segment 6.

According to one embodiment, the method does not include the step ofinserting a bone anchor through the mesh portion 23, for example throughan aperture 31 of the mesh portion 23.

LIST OF EXAMPLES

A non-exhaustive list of examples of the bone fixation system 12, theimplants 20, 120, 220, and 320, and methods of use of the bone fixationsystem 12 and the implants 20, 120, 220, and 320 described above isprovided below.

Example 1

An implant configured to be secured to a bone, the implant comprising: aplate portion; and an implant portion, wherein the implant defines anouter perimeter defined by at least partially by the plate portion andfurther defined at least partially by the mesh portion.

Example 2

The implant of example 1, wherein the plate portion includes a platebody that defines an inner plate surface and an outer plate surface, theinner plate surface configured to face the bone, the outer plate surfaceopposite the inner plate surface.

Example 3

The implant of example 2, wherein the inner plate surface is spaced fromthe outer plate surface with respect to a first direction, and the plateportion defines a plate height measured from the inner plate surface tothe outer plate surface along the first direction.

Example 4

The implant of example 3, wherein the mesh portion includes a mesh bodythat defines an inner mesh surface and an outer mesh surface, the innermesh surface configured to face the bone, the outer mesh surfaceopposite the inner mesh surface.

Example 5

The implant of example 4, wherein the inner mesh surface is spaced fromthe outer mesh surface with respect to a second direction, the meshportion defines a mesh height measured from the inner mesh surface tothe outer mesh surface along the second direction, and the mesh heightis less than the plate height.

Example 6

The implant of example 5, wherein the first direction is parallel to thesecond direction.

Example 7

The implant of example 5, wherein the first direction is non-parallel tothe second direction.

Example 8

The implant of any one of examples 5 to 7, wherein the plate portionincludes a bone fixation hole that extends through the plate bodybetween the inner plate surface and the outer plate surface, and thebone fixation hole is configured to receive a bone anchor to secure theimplant to the bone.

Example 9

The implant of example 8 wherein plate body defines a central hole axis,and the bone fixation hole extends along the central hole axis betweenthe inner plate surface and the outer plate surface.

Example 10

The implant of example 9, wherein the central hole axis is parallel tothe first direction.

Example 11

The implant of any one of example 8 to 10, wherein the bone fixationhole is a first bone fixation hole, the plate portion includes a secondbone fixation hole that extends through the plate body between the innerplate surface and the outer plate surface.

Example 12

The implant of example 11, wherein the plate height is measured at alocation between the first bone fixation hole and the second bonefixation hole.

Example 13

The implant of example 12, wherein the plate body defines a side platesurface that extends between the inner plate surface and the outer platesurface such that the side plate surface, and the side plate surfacedefines an outer plate perimeter that encloses all of the bone fixationholes of the implant that are configured to receive a bone anchorconfigured to secure the implant to the bone.

Example 14

The implant of example 13, wherein the mesh portion extends out from aportion of the side plate surface.

Example 15

The implant of any one of examples 13 to 14, wherein the mesh portiondefines an aperture that extends through the mesh body between the innermesh surface and the outer mesh surface.

Example 16

The implant of example 15, wherein the aperture is smaller than all ofthe bone fixation holes of the implant such that the aperture is notconfigured to receive the bone anchor.

Example 17

The implant of example 16, wherein the mesh portion defines a pluralityof apertures, the mesh body includes a side mesh surface that extendsbetween the inner mesh surface and the outer mesh surface, and the sidemesh surface defines an outer mesh perimeter that encloses the pluralityof apertures.

Example 18

The implant of example 17, wherein the plurality of apertures includesan inner aperture and an outer aperture, the inner aperture including afully enclosed perimeter defined by the mesh body, and the outeraperture extends into the mesh body toward the plate portion.

Example 19

The implant of example 18, wherein the mesh portion includes a firstpetal and a second petal, the first petal separated from the secondpetal by the outer aperture such that the first petal is independentlyflexible relative to the second petal.

Example 20

The implant of any one of examples 1 to 19, wherein the mesh portion isa first mesh portion, the implant includes a second mesh portionseparated from the first mesh portion by the plate portion.

Example 21

The implant of example 20, wherein the implant includes a third meshportion separated from the second mesh portion by the plate portion.

Example 22

The implant of any one of examples 1 to 21, wherein the mesh portion ismore flexible than the plate portion.

Example 23

The implant of any one of example 1 to 22, wherein the plate portion isconfigured to be secured to a first segment of a tibia by a first boneanchor, the plate portion is configured to be secured to a secondsegment of the tibia by a second bone anchor, and the mesh portion isconfigured to abut a third segment of the tibia.

Example 23

The implant of any one of example 1 to 22, wherein the plate portion isconfigured to be secured to a first segment of a calcaneus by a firstbone anchor, the plate portion is configured to be secured to a secondsegment of the calcaneus by a second bone anchor, and the mesh portionis configured to abut a third segment of the calcaneus.

Example 23

The implant of any one of example 1 to 22, wherein the plate portion isconfigured to be secured to a first segment of a radius by a first boneanchor, the plate portion is configured to be secured to a secondsegment of the radius by a second bone anchor, and the mesh portion isconfigured to abut a third segment of the radius.

Example 24

A kit comprising: the implant of any one of claims 1 to 23; and aplurality of bone anchors configured to secure the implant to the bone.

Example 25

The kit of example 24, wherein the plurality of bone anchors includes aplurality of bone screws.

Example 26

The kit of example 25, wherein the plurality of bone screws includescompression screws, locking screws, variable angle locking screws, andany combination thereof.

Each of these non-limiting examples can stand on its own, or can becombined in various permutations or combinations with one or more of theother examples.

It will be appreciated that the foregoing description provides examplesof the disclosed system and technique. However, it is contemplated thatother implementations of the disclosure may differ in detail from theforegoing examples. All references to the disclosure or examples thereofare intended to reference the particular example being discussed at thatpoint and are not intended to imply any limitation as to the scope ofthe disclosure more generally. All language of distinction anddisparagement with respect to certain features is intended to indicate alack of preference for those features, but not to exclude such from thescope of the disclosure entirely unless otherwise indicated.

Recitation of ranges of values herein are merely intended to serve as ashorthand method of referring individually to each separate valuefalling within the range including the stated ends of the range, unlessotherwise indicated herein, and each separate value is incorporated intothe specification as if it were individually recited herein. All methodsdescribed herein can be performed in any suitable order unless otherwiseindicated herein or otherwise clearly contradicted by context.

Although the disclosure has been described in detail, it should beunderstood that various changes, substitutions, and alterations can bemade herein without departing from the spirit and scope of the inventionas defined by the appended claims. Moreover, the scope of the presentdisclosure is not intended to be limited to the particular embodimentsdescribed in the specification. As one of ordinary skill in the art willreadily appreciate from the disclosure of the present invention,processes, machines, manufacture, composition of matter, means, methods,or steps, presently existing or later to be developed that performsubstantially the same function or achieve substantially the same resultas the corresponding embodiments described herein may be utilizedaccording to the present disclosure.

What is claimed:
 1. An implant comprising: a plate portion; and a meshportion that extends from the plate portion, wherein the implant definesan outer perimeter defined at least partially by the plate portion andfurther defined at least partially by the mesh portion.
 2. The implantof claim 1, wherein the plate portion includes a plate body that definesan inner plate surface and an outer plate surface, the inner platesurface configured to face the bone, the outer plate surface oppositethe inner plate surface.
 3. The implant of claim 2, wherein the innerplate surface is spaced from the outer plate surface with respect to afirst direction, and the plate portion defines a plate height measuredfrom the inner plate surface to the outer plate surface along the firstdirection.
 4. The implant of claim 3, wherein the mesh portion includesa mesh body that defines an inner mesh surface and an outer meshsurface, the inner mesh surface configured to face the bone, the outermesh surface opposite the inner mesh surface.
 5. The implant of claim 4,wherein the inner mesh surface is spaced from the outer mesh surfacewith respect to a second direction, the mesh portion defines a meshheight measured from the inner mesh surface to the outer mesh surfacealong the second direction, and the mesh height is less than the plateheight.
 6. The implant of claim 5, wherein the first direction isparallel to the second direction.
 7. The implant of claim 5, wherein theplate portion includes a bone fixation hole that extends through theplate body between the inner plate surface and the outer plate surface,and the bone fixation hole is configured to receive a bone anchor tosecure the implant to the bone.
 8. The implant of claim 7 wherein platebody defines a central hole axis, and the bone fixation hole extendsalong the central hole axis between the inner plate surface and theouter plate surface.
 9. The implant of claim 8, wherein the central holeaxis is parallel to the first direction.
 10. The implant of claim 7,wherein the bone fixation hole is a first bone fixation hole, the plateportion includes a second bone fixation hole that extends through theplate body between the inner plate surface and the outer plate surface.11. The implant of claim 10, wherein the plate height is measured at alocation between the first bone fixation hole and the second bonefixation hole.
 12. The implant of claim 11, wherein the plate bodydefines a side plate surface that extends between the inner platesurface and the outer plate surface such that the side plate surfacedefines an outer plate perimeter that surrounds all of the bone fixationholes of the implant that are configured to receive a bone anchorconfigured to secure the implant to the bone.
 13. The implant of claim12, wherein the mesh portion extends out from a portion of the sideplate surface.
 14. The implant of claim 12, wherein the mesh portiondefines an aperture that extends through the mesh body between the innermesh surface and the outer mesh surface, and the aperture is smallerthan all of the bone fixation holes of the implant such that theaperture is not configured to receive the bone anchor.
 15. The implantof claim 14, wherein the mesh portion defines a plurality of apertures,the mesh body includes a side mesh surface that extends between theinner mesh surface and the outer mesh surface, and the side mesh surfacedefines an outer mesh perimeter that encloses the plurality ofapertures.
 16. The implant of claim 15, wherein the outer perimeter ofthe implant is defined by the outer plate perimeter and the outer meshperimeter.
 17. The implant of claim 15, wherein the plurality ofapertures includes an inner aperture and an outer aperture, the inneraperture including a fully enclosed perimeter defined by the mesh body,and the outer aperture extends into the mesh body toward the plateportion.
 18. The implant of claim 17, wherein the mesh portion includesa first petal and a second petal, the first petal separated from thesecond petal by the outer aperture such that the first petal isindependently flexible relative to the second petal.
 19. The implant ofclaim 14, wherein the mesh portion is a first mesh portion, the implantincludes a second mesh portion separated from the first mesh portion bythe plate portion.
 20. A method of stabilizing a bone, the boneincluding a first bone fragment, a second bone fragment, a third bonefragment, a first defect between the first bone fragment and the secondbone fragment, and a second defect between the second bone fragment andthe third bone fragment, the method comprising the steps of: moving animplant toward the bone, the implant including a plate portion, an meshportion, and an outer perimeter defined in part by the plate portion andin part by the mesh portion; inserting a bone anchor through a firstbone fixation hole defined by the plate portion, and into the first bonesegment; inserting a second bone anchor through a second bone fixationhole defined by the plate portion, and into the second bone segment; andabutting the mesh portion with the third bone segment.